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Bergeron MF, Côté J, Cumming SP, Purcell R, Armstrong N, Basilico L, Burrows K, Charrin JB, Felix A, Groesswang H, Iwasaki Y, Kocher MS, Martowicz M, McConnell K, Moran J, Holm Moseid C, Mountjoy M, Soligard T, Tetelbaum E, Thiel A, Vertommen T, Viseras G, Budgett R, Engebretsen L, Erdener U. IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm. Br J Sports Med 2024:bjsports-2024-108186. [PMID: 39197945 DOI: 10.1136/bjsports-2024-108186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/01/2024]
Abstract
With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.
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Affiliation(s)
- Michael F Bergeron
- Performance Health, WTA Women's Tennis Association, St. Petersburg, Florida, USA
- Health Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Jean Côté
- School of Kinesiology and Health Studies, Queen's University, Kingston, Jamaica, Canada
| | | | - Rosemary Purcell
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Neil Armstrong
- Childrens Health and Exercise Research Centre, University of Exeter, Exeter, UK
| | - Luca Basilico
- World Skate, Maison du Sport International, Lausanne, Switzerland
| | - Kirsty Burrows
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Jean-Benoit Charrin
- Corporate and Sustainable Development Department, International Olympic Committee, Lausanne, Switzerland
| | - Allyson Felix
- Athletes' Commission, International Olympic Committee, Lausanne, Switzerland
| | - Heike Groesswang
- International Bobsleigh & Skeleton Federation (IBSF), Salzburg, Austria
| | - Yasunobu Iwasaki
- Anti-Doping, Medical and Scientific Commission, Fédération Internationale de Gymnastique, Lausanne, Switzerland
- Anshinkai Anshin Hospital, Kobe, Hyogo, Japan
| | - Mininder S Kocher
- Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Magali Martowicz
- Corporate and Sustainable Development Department, International Olympic Committee, Lausanne, Switzerland
| | - Kit McConnell
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Jane Moran
- Medical Commission, International Skating Union, Lausanne, Switzerland
- Faculty of Medicine, The University of British Columbia - Vancouver Campus, Vancouver, British Columbia, Canada
| | - Christine Holm Moseid
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Evgenia Tetelbaum
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Ansgar Thiel
- President, German Sport University, Cologne, Germany
| | - Tine Vertommen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Expertise Center People and Well-being, Thomas More University of Applied Sciences, Antwerp, Belgium
| | - Gloria Viseras
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Uğur Erdener
- Medical and Scientific Commission, International Olympic Committee, Lausanne, Switzerland
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Sore K, Franic F, Androja L, Batarelo Kokic I, Marčinko D, Drmic S, Markser ZV, Franic T. Translation, Cross-Cultural Adaptation, and Validation of the Croatian Version of the Athlete Psychological Strain Questionnaire (APSQ). Sports (Basel) 2024; 12:228. [PMID: 39195604 PMCID: PMC11360386 DOI: 10.3390/sports12080228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 08/12/2024] [Accepted: 08/15/2024] [Indexed: 08/29/2024] Open
Abstract
The aim of this study is to translate, cross-culturally adapt, and validate the Croatian Athlete Psychological Strain Questionnaire (APSQ-Cro) as part of the Sport Mental Health Assessment Tool 1 (SMHAT-1) validation. We assessed the reliability and applicability of the APSQ-Cro among Croatian athletes. The international sports community is increasingly focused on mental health issues in athletes, highlighting the need for early detection tools like the Athlete Psychological Strain Questionnaire (APSQ) and SMHAT-1. We included 869 Croatian competing athletes across 54 sports who received a link to access the WEB-based questionnaire. The Croatian Olympic Board helped in distributing the questionnaires, aiming to reach as many and as diverse a group of registered competing athletes in Croatia as possible. Results showed a Cronbach's alpha of 0.75 for the entire questionnaire, indicating acceptable reliability. An exploratory strategy of factor analysis was used to determine the underlying structure of the APSQ-Cro. For this purpose, the Kaiser-Meyer-Olkin (KMO) test and Bartlett's test for sphericity were performed to ensure the suitability of the data. The KMO test ensured sampling adequacy, with a measure of 0.77 indicating suitability for factor analysis, while Bartlett's test confirmed significant correlations among variables (χ2 = 2779.155, df = 45, p < 0.001), validating the dataset's appropriateness for data reduction techniques. The factor analysis, together with the Cattell scree test and varimax rotation, resulted in a two-factor structure for the APSQ-Cro. Factor 1 included items related to internal psychological struggles, while Factor 2 included items related to external pressures from the athletic environment. These two factors explained 53% of the variability, with Cronbach's alphas of 0.75 and 0.88 for the respective factors. The APSQ-Cro is a valid and reliable tool for assessing distress in Croatian athletes. Croatian athletes' sporting experience will be improved with the broad adoption of the APSQ-Cro, which can help detect early signs of psychological distress and subsequently improve mental health outcomes.
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Affiliation(s)
- Katarina Sore
- School of Medicine, University of Split, 21000 Split, Croatia (T.F.)
| | - Frane Franic
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Luka Androja
- School of Medicine, University of Split, 21000 Split, Croatia (T.F.)
- Department of Sports Management, Aspira University of Applied Sciences, 21000 Split, Croatia
| | - Ivana Batarelo Kokic
- Faculty of Humanities and Social Sciences, University of Split, 21000 Split, Croatia;
| | - Darko Marčinko
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Psychiatry, University Hospital Zagreb, 10000 Zagreb, Croatia
| | - Stipe Drmic
- Department of Psychiatry, Dubrava University Hospital, 10000 Zagreb, Croatia;
- Department of Health Studies, University of Split, 21000 Split, Croatia
- University of Applied Health Sciences, 10000 Zagreb, Croatia
| | | | - Tomislav Franic
- School of Medicine, University of Split, 21000 Split, Croatia (T.F.)
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Kew ME, Dave U, Marmor W, Olsen R, Jivanelli B, Tsai SHL, Kuo LT, Ling DI. Sex Differences in Mental Health Symptoms in Elite Athletes: A Systematic Review and Meta-analysis. Sports Health 2024:19417381241264491. [PMID: 39129353 DOI: 10.1177/19417381241264491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024] Open
Abstract
CONTEXT Mental health is a growing area of concern for elite athletes. OBJECTIVE To determine the sex differences in mental health symptoms in elite athletes. DATA SOURCES PubMed, EMBASE, and Cochrane Library databases were used. STUDY SELECTION Included studies included comparisons of mental health symptoms of athletes by sex. STUDY DESIGN Systematic review and meta-analysis were conducted following the PRISMA guidelines. LEVEL OF EVIDENCE Level 2a. DATA EXTRACTION The rate ratio (RR) was calculated as the rates in female and male athletes. Data were pooled using a random-effects model. RESULTS Of 1945 articles identified, 60 articles were included. Male athletes reported higher alcohol misuse (RR, 0.74; CI, 0.68-0.80), illicit drug abuse (RR, 0.82; CI, 0.75-0.89), and gambling problems (RR, 0.14; CI, 0.08-0.25). Female athletes reported higher overall anxiety (RR, 1.17; CI, 1.08-1.27), depression (RR, 1.42; CI, 1.31-1.54), distress (RR, 1.98; CI, 1.40-2.81), and disordered eating (RR, 2.19; CI, 1.58-3.02). Sleep disturbances were reported at similar rates in male and female athletes (RR, 1.13; CI, 0.98-1.30). CONCLUSION Female and male athletes have significant differences in reported mental health symptoms. Female athletes are more likely to report anxiety, depression, distress, and disordered eating, while male athletes report more alcohol misuse, illicit drug abuse, and gambling. Monitoring and evaluation of mental health is a necessary part of any sport, including access to resources. Longitudinal studies following athletes over time to determine the development and causation for mental health symptoms should be included in future research directions.
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Affiliation(s)
- Michelle E Kew
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York
| | - Udit Dave
- Tulane University School of Medicine, New Orleans, Louisiana
| | - William Marmor
- University of Miami, Department of Orthopaedics, Miami, Florida
| | - Reena Olsen
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York
| | - Bridget Jivanelli
- Kim Barrett Memorial Library, HSS Education Institute, Hospital for Special Surgery, New York, New York
| | - Sung Huang Laurent Tsai
- Division of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Chiayi County, Taiwan and School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Liang-Tseng Kuo
- School of Medicine, Chang Gung University, Taoyuan, Taiwan and Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
| | - Daphne I Ling
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and Department of Population Health Sciences, Weill Cornell Medical College, New York, New York
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Lundqvist C, Schary DP, Jacobsson J, Korhonen L, Timpka T. Aligning categories of mental health conditions with intervention types in high-performance sports: A narrative cornerstone review and classification framework. J Sci Med Sport 2024; 27:525-531. [PMID: 38796375 DOI: 10.1016/j.jsams.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/16/2024] [Accepted: 05/07/2024] [Indexed: 05/28/2024]
Abstract
Epidemiological studies suggest that psychiatric disorders are as prevalent amongst high-performance athletes as in general populations, challenging the myth of invulnerability. Despite efforts of sport organisations to highlight the significance of athletes' mental health, it is still many times tough to combine the sport performance ethos with a discourse on mental health. This narrative cornerstone review examines challenges related to definitions and classifications of athlete mental health in high-performance sports and how these influence assessments and the implementation of interventions. We discuss challenges with concept creep and psychiatrisation and outline their consequences for sport healthcare professionals. Based on this, we present a framework that aligns different categories of athlete mental health conditions (from the reduction of wellbeing to psychiatric disorders) with intervention types (from the provision of supporting environments to pharmacotherapy). We conclude that researchers and sport practitioners need to carefully consider conceptual creep and the risk of pathologising normal and healthy, albeit emotionally aversive, reactions to athlete lifeworld events when assessing athlete mental health. A clear separation of terminology denoting the athlete's resources to handle the lifeworld (including salutogenic factors) and terms describing psychiatric conditions and their management is necessary to avoid misguidance in intervention planning.
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Affiliation(s)
- Carolina Lundqvist
- Department of Behavioural Sciences and Learning, Linköping University, Sweden; Athletics Research Center, Linköping University, Sweden.
| | - David P Schary
- Department of Physical Education, Sport and Human Performance, Winthrop University, USA. https://twitter.com/DrDavidSchary
| | - Jenny Jacobsson
- Athletics Research Center, Linköping University, Sweden; Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Sweden
| | - Toomas Timpka
- Athletics Research Center, Linköping University, Sweden; Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Sweden; Regional Executive Office, Region Östergötland, Sweden
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Tadmor DI, Chesson L, Till K, Phillips G, Fairbank L, Brown J, Cross M, Gardner AJ, Johnston RD, Owen C, Hendricks S, Stokes KA, Jones B. Non-reporting of sport-related concussion symptoms: a cross-sectional study of community rugby league players in the UK. Inj Prev 2024:ip-2023-045108. [PMID: 39060115 DOI: 10.1136/ip-2023-045108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
Recognising and removing players with suspected sport-related concussions is crucial for community sports. OBJECTIVES Quantify rates and factors associated with non-reporting of concussion symptoms in community rugby league. METHODS Overall, 484 community rugby league players aged ≥18 years and 965 parents of rugby league players aged <18 years completed an online survey, regarding concussion history, knowledge, prevalence and reasons for non-reporting of concussion, long-term implications and perceptions of concussion. RESULTS Thirty-five percent of players aged ≥18 years and 22% of parents of players aged <18 years reported at least one concussion in the last two seasons. Forty-three percent of players aged ≥18 years and 5% of parents of players aged<18 years surveyed stated they did not report concussion-related symptoms sustained during 2020 and 2021 seasons. The two most common reasons for non-reporting of concussion symptoms were 'didn't want to be ruled out of a match' and 'didn't want to let down the team'. Players aged ≥18 years who received external coaching pressures around concussion were more likely to not report concussion symptoms. Over 40% of parents and players were concerned about the potential long-term implications. Ten percent of players aged ≥18 years and 7% of parents of players aged <18 years would encourage their family members/children to not play rugby league. CONCLUSIONS Non-reporting rates of suspected concussion symptoms in adult community players were twice as high as in professional rugby league, with similar reasons (wanting to play and not letting the team down). Engaging coaches to prioritise brain health and providing broader and appropriate education on concussion should be focused on, given the concerns reported by community players and parents.
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Affiliation(s)
- Daniel Isaac Tadmor
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | - Lucy Chesson
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | - Gemma Phillips
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Hull Kingston Rovers, Hull, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Uno-X Mobility Professional Cycling, Oslo, Norway
| | - Laura Fairbank
- England Performance Unit, Rugby Football League, Manchester, UK
| | - James Brown
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch, South Africa
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Matt Cross
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Premiership Rugby, London, UK
| | - Andrew J Gardner
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Rich D Johnston
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Brisbane, Queensland, Australia
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Keith A Stokes
- Centre for Health, and Injury & Illness Prevention in Sport, University of Bath, Bath, UK
- Rugby Football Union, Twickenham, UK
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Premiership Rugby, London, UK
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
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Shen S, Lin Y, Sun J, Liu Y, Chen Y, Lu J. A New Tissue Engineering Strategy to Promote Tendon-bone Healing: Regulation of Osteogenic and Chondrogenic Differentiation of Tendon-derived Stem Cells. Orthop Surg 2024. [PMID: 39043618 DOI: 10.1111/os.14152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 07/25/2024] Open
Abstract
In the field of sports medicine, repair surgery for anterior cruciate ligament (ACL) and rotator cuff (RC) injuries are remarkably common. Despite the availability of relatively effective treatment modalities, outcomes often fall short of expectations. This comprehensive review aims to thoroughly examine current strategies employed to promote tendon-bone healing and analyze pertinent preclinical and clinical research. Amidst ongoing investigations, tendon-derived stem cells (TDSCs), which have comparatively limited prior exploration, have garnered increasing attention in the context of tendon-bone healing, emerging as a promising cell type for regenerative therapies. This review article delves into the potential of combining TDSCs with tissue engineering methods, with ACL reconstruction as the main focus. It comprehensively reviews relevant research on ACL and RC healing to address the issues of graft healing and bone tunnel integration. To optimize tendon-bone healing outcomes, our emphasis lies in not only reconstructing the original microstructure of the tendon-bone interface but also achieving proper bone tunnel integration, encompassing both cartilage and bone formation. In this endeavor, we thoroughly analyze the transcriptional and molecular regulatory variables governing TDSCs differentiation, incorporating a retrospective analysis utilizing single-cell sequencing, with the aim of unearthing relevant signaling pathways and processes. By presenting a novel strategy rooted in TDSCs-driven osteogenic and chondrogenic differentiation for tendon-bone healing, this study paves the way for potential future research avenues and promising therapeutic applications. It is anticipated that the findings herein will contribute to advancing the field of tendon-bone healing and foster the exploration of TDSCs as a viable option for regenerative therapies in the future.
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Affiliation(s)
- Sinuo Shen
- School of Medicine, Southeast University, Nanjing, China
- The Center of Joint and Sports Medicine, Orthopedics Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yucheng Lin
- School of Medicine, Southeast University, Nanjing, China
- The Center of Joint and Sports Medicine, Orthopedics Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jiachen Sun
- School of Medicine, Southeast University, Nanjing, China
- The Center of Joint and Sports Medicine, Orthopedics Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuanhao Liu
- School of Medicine, Southeast University, Nanjing, China
- The Center of Joint and Sports Medicine, Orthopedics Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuzhi Chen
- School of Medicine, Southeast University, Nanjing, China
- The Center of Joint and Sports Medicine, Orthopedics Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jun Lu
- School of Medicine, Southeast University, Nanjing, China
- The Center of Joint and Sports Medicine, Orthopedics Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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7
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Gao Y, Wang L. A study on the relationship and path between mental health and burnout of Chinese athletes. Front Psychol 2024; 15:1422207. [PMID: 39100557 PMCID: PMC11295933 DOI: 10.3389/fpsyg.2024.1422207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/27/2024] [Indexed: 08/06/2024] Open
Abstract
Background This study aims to explore the relationship and influencing pathways between mental health indicators and athlete burnout among Chinese competitive athletes. Methods A cross-sectional study was conducted on 501 elite Chinese athletes from several national and provincial sports teams. Generalized Anxiety Disorder Scale (GAD-7) was used to measure anxiety, Patient Health Questionnaire (PHQ- 9) was used to measure depression, Athlete Psychological Strain Questionnaire (APSQ) was used to measure perceived stress, and Athlete Burnout Questionnaire (ABQ) was used to measure burnout. The results were derived using reliability testing, descriptive statistics, correlation analyses, and structural equation modeling. Results The following results were obtained: (a) the clinical detection rates of anxiety and depression in this sample were within normal levels, but the detection rate of perceived stress (78.64%) was relatively high; (b) all three mental health indicators were significantly correlated with athlete burnout; (c) in our model, there was a direct path with APSQ directly contributing to 69.95% of the variance in athlete burnout, and two indirect paths with APSQ exerting an indirect effect through depression or/and anxiety accounting for 30.05% of the variance. Conclusion The findings revealed the psychological characteristics of Chinese competitive athletes and the direct and indirect effects of the APSQ on burnout. Future research should actively promote the international development and application of burnout assessment tools, conduct more comprehensive studies on athlete mental health monitoring, and intensify efforts in athlete education, treatment, and support services, as well as strategies for athlete's coping stress.
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Affiliation(s)
- Yun Gao
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
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Castellana MC, Burnett GJ, Gasper A, Nazir MSZ, Leddy JJ, Master CL, Mannix RC, Meehan WP, Willer BS, Haider MN. Adolescents With a High Burden of New-Onset Mood Symptoms After Sport-Related Concussion Benefit From Prescribed Aerobic Exercise, a Secondary Analysis of 2 Randomized Controlled Trials. Clin J Sport Med 2024:00042752-990000000-00212. [PMID: 38980666 DOI: 10.1097/jsm.0000000000001242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 06/06/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE Approximately 20% of students with sport-related concussion (SRC) report new symptoms of anxiety and depression which may be associated with delayed recovery and increased risk for developing a mood disorder. Early prescribed aerobic exercise facilitates recovery in athletes with concussion-related exercise intolerance. We studied the effect of aerobic exercise treatment on new mood symptoms early after SRC. DESIGN Exploratory secondary analysis of 2 randomized controlled trials (RCT). SETTING Sports medicine clinics associated with UB (Buffalo, NY), CHOP (Philadelphia, PA), and Boston Children's Hospital (Boston, MA). PARTICIPANTS Male and female adolescents (aged 13-18 years) diagnosed with SRC (2-10 days since injury). INTERVENTIONS Participants were randomized to individualized targeted heart rate aerobic exercise (n = 102) or to a placebo intervention designed to mimic relative rest (n = 96). MAIN OUTCOME MEASURES Incidence of Persisting Post-Concussive Symptoms (PPCS, symptoms ≥28 days). RESULTS First RCT recruited from 2016 to 2018 and the second from 2018 to 2020. Of 198 adolescents, 156 (79%) reported a low burden (mean 1.2 ± 1.65/24) while 42 (21%) reported a high burden (mean 9.74 ± 3.70/24) of emotional symptoms before randomization. Intervention hazard ratio for developing PPCS for low burden was 0.767 (95% CI, 0.546-1.079; P = 0.128; β = 0.085) and for high burden was 0.290 (95% CI, 0.123-0.683; P = 0.005; β = 0.732). CONCLUSIONS High burden of mood symptoms early after injury increases risk for PPCS, but the sports medicine model of providing early targeted aerobic exercise treatment reduces it. Nonsports medicine clinicians who treat patients with a high burden of new mood symptoms after concussion should consider prescribing aerobic exercise treatment to reduce the risk of PPCS and a mood disorder.
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Affiliation(s)
- Matthew C Castellana
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York
| | - George J Burnett
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York
- Buffalo Psychiatric Center, Buffalo, New York
| | - Andrew Gasper
- Buffalo Psychiatric Center, Buffalo, New York
- Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York
| | - Muhammad S Z Nazir
- University Concussion Management Clinic and Research Center, UBMD Orthopaedics and Sports Medicine, Buffalo, New York
| | - John J Leddy
- UBMD Department of Orthopaedics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York
| | - Christina L Master
- Departments of Surgery and Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rebekah C Mannix
- Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts; and
| | - William P Meehan
- Department of Pediatrics and Orthopedics, Harvard Medical School, Boston, Massachusetts
| | - Barry S Willer
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York
| | - Mohammad N Haider
- UBMD Department of Orthopaedics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York
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9
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Prior E, Papathomas A, Rhind D. Navigating athlete mental health: Perspectives from performance directors within elite sport. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 73:102661. [PMID: 38735507 DOI: 10.1016/j.psychsport.2024.102661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
Performance directors lead high-performance programmes within elite sport and where they opt to invest resources has implications for athletes. This study explores performance directors' perspectives on mental health and illness and their experiences of managing these within elite sport. We conducted semi-structured interviews with 11 performance directors, resulting in 18 h of data. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. We constructed three themes: 1) making sense of mental health: legitimacy vs. scepticism; 2) mental health as athlete responsibility; and 3) simplifying and sanitising mental health. Performance directors used physical health analogies to make sense of mental health, sometimes describing unrealistic expectations regarding mental health management. They also positioned athletes as responsible for finding solutions to their mental health concerns, at times overlooking the impact of the elite sport environment. Some performance directors shared over-simplified perceptions of mental health, often focusing on 'the positive' and neglecting to talk about the more challenging aspects of mental health and illness. Educating performance directors, as well as others in leadership positions, on the complexities of mental health and illness is recommended. This should include how mental illness differs from physical illness and injury, how to respond when athletes disclose mental health concerns, and how mental illness recovery is often nonlinear and subjectively defined.
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Affiliation(s)
- Erin Prior
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK.
| | - Anthony Papathomas
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel Rhind
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
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10
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Gill VS, Sullivan G, Stearns H, Tummala SV, Haglin JM, Economopoulos KJ, Marks L, Chauhan M. Mental Health in Elite Athletes: A Systematic Review of Suicidal Behaviour as Compared to the General Population. Sports Med 2024; 54:1-18. [PMID: 38407749 DOI: 10.1007/s40279-024-01998-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND AND OBJECTIVE Previous systematic reviews on mental health in athletes have found athletes to be at a potentially increased risk for mental health diagnoses compared to the public. Multiple cross-sectional studies have examined suicide behaviour within different athlete populations, but there is a need for a comprehensive review to synthesize and identify risk factors and epidemiology regarding suicide behaviour in the elite athlete population, especially as it compares to the general population. METHODS A systematic literature search was performed in MEDLINE, EMBASE, Scopus, and Web of Science from 1990 to January 2023. Inclusion criteria included original peer-reviewed research articles examining suicidal ideation, suicide attempt, or suicide completion within elite athlete populations. Exclusion criteria included athletes participating in high-school or Paralympic level sports, studies that did not report results regarding elite athletes and non-athletes separately, and non-peer reviewed work. All studies were screened for inclusion by two independent reviewers. The primary outcome variables extracted from included studies included rates, risk factors, and protective factors for suicide behaviour. The study quality and risk of bias was evaluated for each study using the Joanna-Briggs Institute (JBI) critical appraisal tools. RESULTS Of the 875 unique studies identified, 22 studies, all of which were cross-sectional in nature, met the inclusion criteria. Seven studies evaluated previous athletes, 13 studies evaluated current athletes, and two studies included a combination of previous and current athletes. Seven studies involved varsity college athletes, nine involved professional athletes of various sports, and six focused on international or Olympic level athletes. The rate of suicidal ideation in professional athletes ranged from 6.9 to 18% across four studies, while the rate in collegiate athletes ranged from 3.7 to 6.5% across three studies. Ten studies compared athletes to the general population, the majority of which found athletes to be at reduced risk of suicidal ideation, suicide attempt, and suicide completion. Only one study found athletes to have increased rates of suicide compared to matched non-athletes. Risk factors for suicide behaviour identified across multiple studies included male sex, non-white race, older age, and depression. Player position, athletic level, sport played, and injuries showed trends of having limited effect on suicide behaviour risk. CONCLUSION This review suggests that elite athletes generally demonstrate reduced risk of suicidal ideation, suicide attempt, and suicide completion compared to the general population. Coaches should remain aware of specific factors, such as male sex, non-white race, and higher athletic level, in order to better identify at-risk athletes. Limitations of this review include the heterogeneity in the methodology and athlete populations across the included studies. Therefore, future targeted research is essential to compare suicide behaviour between sports and identify sport-specific suicide risk factors. TRIAL REGISTRATION PROSPERO Registration: CRD42023395990.
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Affiliation(s)
- Vikram S Gill
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA.
- Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
| | | | - Hunter Stearns
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | | | - Jack M Haglin
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ, USA
| | | | - Lisa Marks
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Mohit Chauhan
- Department of Psychiatry, Mayo Clinic, Jacksonville, FL, USA
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11
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Aldanyowi SN, AlOraini LI. Personalizing Injury Management and Recovery: A Cross-Sectional Investigation of Musculoskeletal Injuries and Quality of Life in Athletes. Orthop Res Rev 2024; 16:137-151. [PMID: 38779612 PMCID: PMC11108760 DOI: 10.2147/orr.s460748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Purpose The study explores the impact of Musculoskeletal Injuries on the quality of life in youth athletes, aiming to understand the extent of these injuries' effects on their physical and mental wellbeing. Patients and Methods This cross-sectional study included 130 youth athletes, using questionnaires to collect data on demographics, training exposures (averaging 11±3.8 hours/week), overuse symptoms (using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire), acute injury history, and overall wellbeing (assessed by the RAND 36-item Short Form Health Survey). Results Findings indicated that 55.4% of participants had suffered an acute injury in the past 6 months, leading to an average of 4 weeks of time loss. The mean score for OSTRC-O Scores was 16.8±6.4, with knee overuse averaging 21.3± 8.8. In terms of wellbeing, physical and mental health scores were 82.4±15.3 and 81.7±14.1 respectively. There were significant correlations between higher overuse scores and poorer physical functioning (r=-0.42), bodily pain (r=-0.38), vitality (r=-0.32), and mental health (r=-0.31). Acute injuries were linked with worse physical functioning and role limitations. Regression analysis showed that both overuse and acute injuries predicted poorer physical health. Conclusion The study underscores the significant prevalence of musculoskeletal injuries among youth athletes and delineates their profound impact on the quality of life, encompassing both the physical and mental health realms. These findings advocate for the critical integration of preventive measures and personalized training protocols, spotlighting the pivotal role of comprehensive biopsychosocial strategies in nurturing athletes' overall wellbeing. By prioritizing the quality of life as a key outcome, this research advocates for a more nuanced approach to injury management and recovery.
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Affiliation(s)
- Saud N Aldanyowi
- Orthopedic Surgery, College of Medicine, King Faisal University Eastern Province, Al Ahsa, Saudi Arabia
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12
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Bu D, Zhang CQ, Liu JD, Han Z, Wang X, Huang Z. Mental health literacy, mental health experiences and help-seeking behaviours of Chinese elite athletes: a qualitative study. Front Public Health 2024; 12:1391597. [PMID: 38813417 PMCID: PMC11133729 DOI: 10.3389/fpubh.2024.1391597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/15/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Elite athletes' help-seeking on mental health might be influenced by their mental health literacy (MHL) and mental health experiences. The current study aimed to explore the MHL, experiences and help-seeking behaviours among elite athletes using a qualitative approach. Methods Face-to-face semi-structured interviews were conducted among 20 Chinese elite athletes, 12 coaches, and 5 team officials. Interview data was analyzed using content analysis. Results Seven main themes emerged from the analysis. The current study revealed that Chinese elite athletes suffered from various mental health issues and athletes' MHL levels, help-seeking attitudes and intentions, Chinese sports environments, and Chinese cultural background could impact their help-seeking behaviours. Conclusion Support for Chinese elite athletes' mental health and help-seeking requires improvement.
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Affiliation(s)
- Danran Bu
- School of Physical Education, Hubei University, Wuhan, China
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Jing-Dong Liu
- Department of Physical Education, Sun Yat-sen University, Guangzhou, China
| | - Zhe Han
- Key Laboratory of General Administration of Sport of China, Hubei Institute of Sport Science, Wuhan, China
| | - Xiang Wang
- The Department of Sport, Physical Education and Health, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Zhijian Huang
- School of Physical Education, Hubei University, Wuhan, China
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13
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Herring SA, Kibler WB, Putukian M, Blauwet C, Boyajian-O'Neill LA, Boyd J, Franks RR, Indelicato PA, LeClere LE, Logan C, O'Connor FG, Matuszak J, Roberts WO, Sallis RE. Mass Participation and Tournament Event Management for the Team Physician: A Consensus Statement (2022 Update). Curr Sports Med Rep 2024; 23:143-158. [PMID: 38578492 DOI: 10.1249/jsr.0000000000001160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
ABSTRACT Mass participation events include endurance events (e.g., marathon, triathlon) and/or competitive tournaments (e.g., baseball, tennis, football (soccer) tournaments). Event management requires medical administrative and participant care planning. Medical management provides safety advice and care at the event that accounts for large numbers of participants, anticipated injury and illness, variable environment, repeated games or matches, and mixed age groups of varying athletic ability. This document does not pertain to the care of the spectator.
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Affiliation(s)
- Stanley A Herring
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - W Ben Kibler
- Lexington Clinic, Shoulder Center of Kentucky, Lexington, KY
| | | | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA
| | | | - Joel Boyd
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - R Rob Franks
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Peter A Indelicato
- Department of Orthopedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL
| | - Lance E LeClere
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Catherine Logan
- Sports Medicine, Colorado Sports Medicine & Orthopaedics, Denver, CO
| | - Francis G O'Connor
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Jason Matuszak
- Department of Family Medicine, School of Medicine, Excelsior Orthopaedics, University at Buffalo, Buffalo, NY
| | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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14
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Herring SA, Kibler WB, Putukian M, Blauwet C, Boyajian-O'Neill LA, Boyd J, Franks RR, Indelicato PA, Leclere LE, Logan C, O'Connor FG, Matuszak J, Roberts WO, Sallis R. Mass Participation and Tournament Event Management for the Team Physician: A Consensus Statement (2022 Update). Med Sci Sports Exerc 2024; 56:575-589. [PMID: 38485729 DOI: 10.1249/mss.0000000000003325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
ABSTRACT Mass participation events include endurance events (e.g., marathon, triathlon) and/or competitive tournaments (e.g., baseball, tennis, football (soccer) tournaments). Event management requires medical administrative and participant care planning. Medical management provides safety advice and care at the event that accounts for large numbers of participants, anticipated injury and illness, variable environment, repeated games or matches, and mixed age groups of varying athletic ability. This document does not pertain to the care of the spectator.
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Affiliation(s)
- Stanley A Herring
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - W Ben Kibler
- Lexington Clinic, Shoulder Center of Kentucky, Lexington, KY
| | | | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA
| | | | - Joel Boyd
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - R Rob Franks
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Peter A Indelicato
- Department of Orthopedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL
| | - Lance E Leclere
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Catherine Logan
- Sports Medicine, Colorado Sports Medicine & Orthopaedics, Denver, CO
| | - Francis G O'Connor
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Jason Matuszak
- Department of Family Medicine, School of Medicine, Excelsior Orthopaedics, University at Buffalo, Buffalo, NY
| | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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15
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Woodson O, Rungta R, Bassi Smith N, Meuret AE. Depression, anxiety, and suicidal behaviors in a large-scale national survey of student athletes versus non-athlete college students: risk and protective factors. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38442355 DOI: 10.1080/07448481.2024.2317187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 01/30/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE This study investigates the prevalence and risk factors of internalizing disorders and suicidal behaviors in student-athletes and their non-athlete peers. PARTICIPANTS The sample consisted of 223,226 college students (69,404 student-athletes [31.09%]) who participated in the NCHA-ACHA II survey (Fall 2015-2018). METHODS Items from the NCHA-ACHA II were used to assess severity of depression, anxiety, and suicidal behaviors. Chi-squared Test of Independence and multinomial logistic regressions were used to examine self-reported internalizing symptoms, previous diagnosis, previous use of mental health resources, and suicidal behaviors within student-athletes and non-athletes. RESULTS Findings indicated high rates of internalizing symptoms. Student-athletes, both varsity and intramural/club, displayed decreased odds of internalizing symptoms, self-reported mental health diagnosis, and suicidal behaviors. CONCLUSIONS This study with a national sample expands previous studies showing concerning rates of mental health difficulties, student-athletes demonstrated lower odds. These findings highlight the importance of further research and need for targeted intervention within this population.
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Affiliation(s)
- Olivia Woodson
- Department of Psychology, Southern Methodist University, Dallas, Texas, USA
| | - Ria Rungta
- Department of Chronic Disease Epidemiology Health, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Noelle Bassi Smith
- Department of Veterans Affairs, Northeast Program Evaluation Center, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, Texas, USA
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16
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Zeller AM, Lear A, Post E, McNulty S, Bentley B. A National Survey on the Relationship of Youth Sport Specialization Behaviors to Self-Reported Anxiety and Depression in Youth Softball Players. Sports Health 2024; 16:184-194. [PMID: 38344769 PMCID: PMC10916774 DOI: 10.1177/19417381241228539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND There are little to no data on whether any associations exist between sport specialization and mental health in youth softball athletes. HYPOTHESIS Highly specialized youth softball athletes will have worse self-reported depression and anxiety symptom scores compared with low and moderate specialized athletes. STUDY DESIGN Cross-sectional survey. LEVEL OF EVIDENCE Level 4. METHODS An online cross-sectional survey was distributed in the fall of 2021 to a national sample of female youth softball athletes between the ages of 12 and 18 years. Sport specialization status was determined using a 3-point specialization scale that classifies either low, moderate, or high. The patient health questionnaire-9 (PHQ-9) and the 7-item general anxiety disorder scale (GAD-7) were used to assess self-reported symptoms of depression and anxiety. Comparison also included sports participation and specialization behaviors between specialization groups. RESULTS A total of 1283 subjects (mean age, 15.1 ± 1.7 years) fully completed the survey. After adjusting for covariates, lower scores were reported on both the PHQ-9 and GAD-7 by highly specialized athletes compared with moderate or low specialization athletes (PHQ-9, high = 8.6 ± 0.4; moderate = 11.2 ± 0.3; low = 10.9 ± 0.5; P < 0.01; GAD-7, high = 6.5 ± 0.4; moderate = 8.6 ± 0.3; low = 8.4 ± 0.4, P < 0.01). Conversely, higher scores were reported on both scales for athletes who received private softball coaching compared with those who did not (PHQ-9, 11.5 ± 0.3 vs 9.0 ± 0.3; P < 0.01; GAD-7, 8.8 ± 0.3 vs 6.9 ± 0.3, P < 0.01). Finally, athletes who reported an arm overuse injury in the previous year reported higher PHQ-9 scores (10.8 ± 0.3 vs 9.8 ± 0.3; P < 0.01). CONCLUSION While sport specialization, as measured by the validated 3-point scale, was not associated with increased anxiety and depression symptom scores, other aspects of specialization behavior such as private coaching or overuse injury history were associated with worse scores on these scales, indicating potential concern for anxiety and depression. However, although the differences we observed were statistically significant, they did not exceed the minimal clinically important difference values that have been established for the PHQ-9 (5 points) or GAD-7 (4 points). CLINICAL RELEVANCE This project is a first step toward understanding the sport specialization behaviors and their influence on the mental health of youth softball athletes. Focusing on investigating specialization behaviors further may reveal to be a better indicator of risk of developing anxiety and depression symptoms compared with utilizing the 3-point specialization scale.
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Affiliation(s)
- Anne Marie Zeller
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Knoxville, Tennessee
| | - Aaron Lear
- Cleveland Clinic Akron General, Akron, Ohio
| | - Eric Post
- United States Olympic and Paralympic Committee, Colorado Springs, Colorado
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17
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Thompson T, Kaplan S, Conway R, Miles C. Screening and Referral for Behavioral Health Symptoms in Collegiate Athletes. Clin J Sport Med 2024; 34:112-120. [PMID: 37589957 DOI: 10.1097/jsm.0000000000001185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 07/09/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE We aim to investigate the prevalence of behavioral health symptoms in collegiate athletes and the frequency of referrals prompted by a preparticipation behavioral health screener. DESIGN Athletes completed a screening battery to detect behavioral health symptoms and sports psychology clinicians designed criteria for intervention based on the severity of symptoms reported. Data from the screener was retrospectively de-identified and analyzed. SETTING National Collegiate Athletic Association Division-I university. PARTICIPANTS All athletes on active rosters were required to complete the screener as a component of the preparticipation examination. INTERVENTIONS Sports psychology clinicians created a protocol for intervention based on the number and severity of symptoms reported on the screener. MAIN OUTCOME MEASURES Communication with athletes and referrals made to behavioral health services. RESULTS Of the 1126 surveys completed, 39% had behavioral health symptoms necessitating behavioral health referral. Twelve percent required a safety check-in, given the severity of their symptoms. Seven percent of the respondents were newly established with behavioral health services. CONCLUSIONS Symptoms of behavioral health disorders are common among athletes and yet, for a myriad of reasons, many choose to forgo treatment. By implementing a behavioral health screening battery, the prevalence of behavioral health symptoms among athletes at our institution was elucidated and many athletes were newly established with behavioral health services. The tiered intervention protocol in this study allowed for appropriate assessment and triage of high-risk individuals, while simultaneously providing lower-risk individuals with appropriate resources. Surveillance for behavioral health symptoms among college athletes using a screening battery with a tiered intervention protocol can ensure at-risk athletes are identified, contacted, and referred to behavioral health services, potentially improving their athletic performance and overall well-being, while averting poor outcomes.
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Affiliation(s)
- Tyler Thompson
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Sebastian Kaplan
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Rachel Conway
- Department Sport Psychology, Wake Forest University Athletics, Winston Salem, North Carolina; and
| | - Christopher Miles
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina
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18
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Rogers DL, Tanaka MJ, Cosgarea AJ, Ginsburg RD, Dreher GM. How Mental Health Affects Injury Risk and Outcomes in Athletes. Sports Health 2024; 16:222-229. [PMID: 37326145 PMCID: PMC10916780 DOI: 10.1177/19417381231179678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
CONTEXT The importance of mental health among athletes is becoming more recognized and valued. Athletes experience symptoms of depression, anxiety, and related mental health disorders at rates similar to those of the general population, but because athletes face unique cultural and environmental pressures, such disorders are exacerbated in the context of an injury. Furthermore, we review the less well-known evidence that mental health disorders in athletes are associated with an increased risk of injury. We discuss the increasing awareness of the deficiencies in mental health support for athletes, which has been especially highlighted during the COVID-19 pandemic as well as in prominent professional and Olympic athletes, and describe both internal and external barriers to appropriate care. EVIDENCE ACQUISITION We searched PubMed for pertinent peer-reviewed studies. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 5. RESULTS There is a known psychological response to injury that can prolong recovery from musculoskeletal injury; conversely, mental health disorders in athletes are not only associated with an increased injury risk but also portend poorer outcomes subsequently, including prolonged recovery times, increased rates of injury recurrence, decreased rates of return to sport, and reduced performance upon return. Because of inherent barriers to appropriate care of athletes, including identification, stigma, and resource availability, there are currently various ongoing efforts nationally to create and implement initiatives regarding athlete mental health screening, support systems, and directed interventions to address the inextricably linked physical and mental health of athletes. CONCLUSION Athletic injury negatively impacts the mental health of athletes. Likewise, mental health can and does influence athletic performance and is also intimately tied to the risk of athletic injury, thus creating a complex cycle with inability to separate physical and mental health.
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Affiliation(s)
- Davis L Rogers
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew J Cosgarea
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Richard D Ginsburg
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Geoffrey M Dreher
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
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Singh A, Kaur Arora M, Boruah B. The role of the six factors model of athletic mental energy in mediating athletes' well-being in competitive sports. Sci Rep 2024; 14:2974. [PMID: 38316915 PMCID: PMC10844369 DOI: 10.1038/s41598-024-53065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/27/2024] [Indexed: 02/07/2024] Open
Abstract
In the realm of high-performance sports, athletes often prioritize success at the expense of their well-being. Consequently, sports psychology researchers are now focusing on creating psychological profiles for athletes that can forecast their performance while safeguarding their overall well-being. A recent development in this field is the concept of athletic mental energy (AME), which has been associated with both sporting success and positive emotions. Therefore, the aim of this study was to explore if AME in athletes can mediate this directly observed relationship between performance and psychological well-being. For stronger predictive validity these relationships were examined across two studies with each involving distinct sets of participants engaged in various sports disciplines, including football, cricket, basketball, archery, and more. The self-report measures of sports performance, athletic mental energy (AME), and psychological well-being (PWB) were administered post-competition on the local, regional, state, national, international, and professional level athletes of age 18 and above. Our study found that both, the affective and cognitive components of AME mediated the athletes' performance and psychological well-being relationship. Interestingly, the study found no significant gender differences in AME and PWB scores. While family structures didn't yield significant variations in AME scores, there were some descriptive distinctions in PWB scores across different family structures. Our research offers preliminary evidence suggesting that AME can play a pivotal role in preserving athletes' psychological well-being following competitive events.
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Affiliation(s)
- Amisha Singh
- Department of Psychology, University of Delhi, New Delhi, India.
| | - Mandeep Kaur Arora
- Department of Psychology, Kamala Nehru College, University of Delhi, New Delhi, 110007, India
| | - Bahniman Boruah
- Department of Psychology, University of Delhi, New Delhi, India
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20
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Baumann L, Schneeberger AR, Currie A, Iff S, Seifritz E, Claussen MC. Mental Health in Elite Coaches. Sports Health 2024:19417381231223472. [PMID: 38246889 DOI: 10.1177/19417381231223472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
CONTEXT Coaches play an important role in promoting mental health in elite sports. However, they themselves are exposed to risks affecting their mental health, and their fears and worries are often overlooked. Moreover, it remains unclear how coaches' mental health affects their athletes' mental health. OBJECTIVE To create a compilation of the literature on (1) elite coaches' mental health and (2) how coaches' mental health influences elite athletes' mental health. Building on this, recommendations for improving coaches' psychological well-being should be elaborated upon and discussed. DATA SOURCES A literature search was conducted up to November 30, 2021, using the following databases: PubMed, PsycINFO, Scopus, Web of Science, and SportDiscus. STUDY SELECTION Studies reporting elite coaches' mental health symptoms and disorders and the influence of elite coaches' mental health on elite athletes' mental health were included. STUDY DESIGN Scoping review. LEVEL OF EVIDENCE Level 4. DATA EXTRACTION Data regarding elite coaches' mental health, as well as their influence on athletes' mental health and performance, were included in a descriptive analysis. The PRISMA guidelines were used to guide this review. RESULTS Little research has been done on elite coaches' mental health disorders, although studies confirm that they do experience, for example, symptoms of burnout, anxiety, and depression. The influence of coaches' mental health on their athletes is underinvestigated, with research focused mainly on the influence of coaches' stress. CONCLUSION Knowledge about coaches' mental health is still limited. Coaches' poor mental health diminishes coaching performance and might impair athletes' mental health. Coaches should receive more support, including sports psychiatric care and education on the importance of mental health. This could improve the mental health of both coaches and athletes, and positively affect athlete performance.
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Affiliation(s)
- Laura Baumann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Alan Currie
- Regional Affective Disorders Service, Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK
- Exercise Sport and Rehabilitation Therapies, University of Sunderland, Sunderland, UK
| | - Samuel Iff
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Malte Christian Claussen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Clinic for Depression and Anxiety, Psychiatric Centre Münsingen, Switzerland
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21
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Abstract
There is growing understanding of the extent of mental health problems, and related mental health needs, among elite athletes. However, far less attention has been paid to mental health among elite coaches and high-performance support staff, the latter including strength and conditioning coaches, physiotherapists, sport psychologists, and other allied health workers in the daily training environment (high-performance support staff are referred to collectively as "entourage" throughout this article). The scarcity of research examining mental health among elite coaches and entourage warrants urgent attention, particularly given these individuals share similar performance demands and role-related stressors as elite athletes. This article reviews the available literature on this topic, including (1) an empirical study conducted by the authors with a sample of coaches and entourage from Australia's national high-performance sport system and (2) a case example to illustrate sport-specific and general risk factors that are likely to impact mental health in elite sporting environments. Avenues for supporting mental health among coaches and entourage are discussed.
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Affiliation(s)
- Rosemary Purcell
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Elite Sports and Mental Health, Orygen, 35 Poplar Road, Parkville, Victoria 3052, Australia.
| | - Joshua Frost
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Elite Sports and Mental Health, Orygen, 35 Poplar Road, Parkville, Victoria 3052, Australia
| | - Vita Pilkington
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Elite Sports and Mental Health, Orygen, 35 Poplar Road, Parkville, Victoria 3052, Australia
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22
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Beable SE. Depressive Disorders in Athletes. Clin Sports Med 2024; 43:53-70. [PMID: 37949514 DOI: 10.1016/j.csm.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Depressive disorders in athletes are thought to be at least as common as the general population. However, athletes have a unique set of risk factors that can affect the likelihood of developing depression. Screening tools have been developed specifically for athletes such as the Sport Mental Health Assessment Tool (SMHAT). The management of the depressed athlete should involve an individualized approach, with methods such as counseling, interpersonal therapy, or cognitive behavioral therapy being used. Some may require antidepressant medication. Depressive disorders are also linked to sucidality in athletes, and the team physician and sporting organisation should have a crisis management plan in place for mental health emergencies. Tackling the stigma that remains in sport is a key part to improving mental wellbeing for all athletes.
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Affiliation(s)
- Sarah E Beable
- High Performance Sport New Zealand, Axis Sports Medicine Specialists, 15/5 Hawthorne Drive, Queenstown 9304, New Zealand.
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23
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Lima Y, Rice S. Mental health symptoms and correlates among amateur football players: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1617-1628. [PMID: 35968854 DOI: 10.1080/09603123.2022.2112659] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
The objective of this study was to evaluate mental health problems reported by Turkish amateur football players. A total of 4516 Turkish amateur football players were invited to complete an anonymous online survey including demographic and COVID-19 pandemic related questions, the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, and Athlete Psychological Strain Questionnaire. A total of 1263 players participated in the study (27.9% response rate). Single players reported higher depression and anxiety scores than married players. Higher depression, anxiety, and athletes-specific stress scores were reported by players with an annual income <$5,000 and those reporting an income loss >75% during the COVID-19 pandemic. Players with a sports injury history, psychiatric illness, sleep problems, and perceived inadequate social and/or organizational support reported poorer indices relative to their counterparts. Implementation of mental health screening among amateur football players may assist in detecting vulnerabilities and initiating appropriate timely intervention.
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Affiliation(s)
- Yavuz Lima
- Sports Medicine Department, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
| | - Simon Rice
- Orygen, Centre for Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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24
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Cansler R, Heidrich J, Whiting A, Tran D, Hall P, Tyler WJ. Influence of CrossFit and Deep End Fitness training on mental health and coping in athletes. Front Sports Act Living 2023; 5:1061492. [PMID: 37849685 PMCID: PMC10577405 DOI: 10.3389/fspor.2023.1061492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 09/19/2023] [Indexed: 10/19/2023] Open
Abstract
Physical exercise is known to improve mental health. Athletes can experience unique physical and emotional stressors, which can deteriorate mental health and cognitive function. Training apathy can lead to cognitive dissonance and further degrade performance by promoting maladaptive, avoidance coping strategies. Introduction of psychosocial and training variables, such as those used in CrossFit (CF) and other community-based fitness programs with strong peer support have been shown to help reduce training apathy and negative affect. Here, we explored whether addition of psychophysiological variation, experienced as "hunger for air" during underwater breath-hold exercises, could provide unique mental health benefits for athletes. We studied the influence of CF and Deep End Fitness (DEF), a community-based underwater fitness program, on several outcome measures of mental health and emotional well-being in volunteer athletes. We observed a significant reduction in stress scores of both the control CF training group and the experimental DEF group. We found that DEF produced a significant improvement in positive affect while CF training did not. Further supportive of our hypothesis that the psychological and biological stressors experienced in underwater, breath-hold training cause positive adaptive changes and benefits, DEF training uniquely increased problem-based coping. While our observations demonstrate both CF and DEF training can improve mental health in athletes, DEF produced additional, unique benefits to positive coping and attitudes of athletes. Future studies should further evaluate the broader benefits of community-based, underwater training programs on psychological and physiological health in athletes and the public.
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Affiliation(s)
- Rachel Cansler
- Department of Psychology, New York University, New York, NY, United States
- Deep End Fitness, San Diego, CA, United States
| | | | - Ali Whiting
- Deep End Fitness, San Diego, CA, United States
| | - Don Tran
- Deep End Fitness, San Diego, CA, United States
| | - Prime Hall
- Deep End Fitness, San Diego, CA, United States
| | - William J. Tyler
- Deep End Fitness, San Diego, CA, United States
- IST, LLC, Birmingham, AL, United States
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25
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Junge A, Hauschild A. Behind the Curtain: Prevalence of Symptoms of Depression, Generalised Anxiety and Eating Disorders in 147 Professional Dancers from Six Opera Houses or State Theatres. SPORTS MEDICINE - OPEN 2023; 9:92. [PMID: 37777697 PMCID: PMC10542047 DOI: 10.1186/s40798-023-00638-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Mental health problems cover a wide spectrum. Depression and anxiety disorders are the most frequent mental health problem in the general population and in elite athletes. The aim of the present study was to assess the prevalence of symptoms of depression, generalised anxiety disorder and eating disorders in professional dancers, to compare the results between genders and to the general population and to analyse potential determinants. METHODS During a pre-season health screening, professional dancers of six German companies answered a comprehensive questionnaire on personal and dancer-specific characteristics, medical history and the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Questionnaire (GAD-7) and Eating-Disorder-Examination-Questionnaire (EDE-QS). RESULTS A total of 82 (55.8%) female and 65 (44.2%) male dancers answered the questionnaire. One in five (20.8%) dancers had at least moderate symptoms of either depression, generalised anxiety disorder or eating disorders. The prevalence of at least moderate symptoms of depression was 11.1% in female and 6.4% in male dancers, of generalised anxiety disorder 16.0% in female and 6.4% in male dancers and of eating disorders 14.8% in female and 6.1% in male dancers. Compared to the general population of the same gender and similar age, the prevalence of at least moderate symptoms of generalised anxiety disorder was significantly higher in both genders. About one in four dancers (26.9%) reported a subjective need for support from a psychotherapist at the time of the screening. The PHQ-9, GAD-7 and EDE-QS sum scores were not related to the size or type of the companies, the age or rank of the dancers, but the PHQ-9 and GAD-7 sum score were significantly related to severity of musculoskeletal pain in the past seven days and to chronic or recurrent symptoms of low mood and generalised anxiety. CONCLUSION The prevalence of symptoms of depression, generalised anxiety and eating disorders was high in professional dancers. Routine screening and low-threshold interventions to improve mental health of professional dancers are recommended.
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Affiliation(s)
- Astrid Junge
- Center for Health in Performing Arts, Medical School Hamburg (MSH), Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Anja Hauschild
- Center for Health in Performing Arts, Medical School Hamburg (MSH), Am Kaiserkai 1, 20457, Hamburg, Germany
- Center for Rehabilitation and Sports Medicine, BG Klinikum Hamburg, Hamburg, Germany
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26
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Mercader-Rubio I, Gutiérrez Ángel N, Brito-Costa S, Silva S, Moisão A, Furtado G. Contributions of one hypothetical model of predictive relationships between psychological skills and emotional intelligence in university student-athletes: A cross-sectional study. Heliyon 2023; 9:e19916. [PMID: 37810159 PMCID: PMC10559329 DOI: 10.1016/j.heliyon.2023.e19916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Psychological skills are considered in sport psychology as indispensable capabilities to analyze the athlete's own vision of his or her own personality. These skills encompass self-confidence, positive and negative coping control, attentional control, visual-imaginative control, motivational level, and attitudinal control. The significance of this research lies in demonstrating the relationship established between each of the dimensions of emotional intelligence and the constituent skills of the personality. As such, this study aims to investigate the relationship between the seven factors related to psychological skills and emotional intelligence (attention, clarity, and emotional regulation). The sample comprises 163 university students pursuing degrees in Physical Activity and Sports Sciences, [70,9% (N = 117) men and 27.9% (N = 46) women] with a mean age of 20.33 years. As assessment instruments, we used two validated and standardized scales, the IPED and the TMMS-24. The main findings of this work allow us to affirm the existence of a relationship between the three dimensions of emotional intelligence and the control of both positive and negative coping, attentional control, visual-imaginative control, motivational level, and attitudinal control. In conclusion, this study underscores the necessity of cognitive and emotional training, in addition to physical training, to enhance these skills among both male and female athletes.
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Affiliation(s)
- Isabel Mercader-Rubio
- Department of Psychology, Faculty of Education Sciences. Universidad de Almería, Spain
| | | | - Sónia Brito-Costa
- Polytechnic of Coimbra, Coimbra Education School, Research Group in Social and Human Sciences (NICSH), Portugal
- Polytechnic Institute of Porto, Center for Research and Innovation in Education (InED), School of Education, Portugal
- Polytechnic Institute of Coimbra, Applied Research Institute, Portugal
- Polytechnic Institute of Coimbra, Human Potential Development Center (CDPH), Portugal
| | - Sofia Silva
- Polytechnic of Coimbra, Coimbra Education School, Research Group in Social and Human Sciences (NICSH), Portugal
- Polytechnic Institute of Porto, Center for Research and Innovation in Education (InED), School of Education, Portugal
| | - Ana Moisão
- Polytechnic of Coimbra, Coimbra Education School, Research Group in Social and Human Sciences (NICSH), Portugal
| | - Guilherme Furtado
- Polytechnic Institute of Coimbra, Applied Research Institute, Portugal
- Center for Studies on Natural Resources, Environment and Society (CERNAS), Polytechnic Institute of Coimbra, Bencanta, 3045-601 Coimbra, Portugal
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27
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Martin EM, Byrd M, Amador A, Ridenhour E, Charalambous C. The Influence of Athletic Identity, Passion, and Perceptions of Severity of Concussions on Athletes' Willingness to Report Concussion Symptoms. J Sport Rehabil 2023; 32:757-763. [PMID: 37236616 DOI: 10.1123/jsr.2022-0246] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 03/28/2023] [Accepted: 04/16/2023] [Indexed: 05/28/2023]
Abstract
CONTEXT The influence of several psychological characteristics on the willingness of athletes to report concussion behaviors has not been well explored. Therefore, the purpose of this study was to understand how athletic identity and sport passion predicted participants' willingness to report symptoms above what was explained by athlete demographics, concussion knowledge, and perceived seriousness of concussions. DESIGN The study was cross-sectional. METHODS Three-hundred and twenty-two male and female high school and club sport athletes completed survey measures of concussion knowledge, athletic identity, harmonious and obsessive passion, and degree to which athletes indicated they would report concussions and concussion symptoms. RESULTS Athletes scored moderately high on their knowledge of symptoms and other concussion information (mean = 16.21; ± = 2.88) and above the midpoint on their attitudes and behaviors toward reporting concussion symptoms (mean = 3.64; ± = 0.70). There were no differences between gender, t(299) = -.78, P = .44, and previous concussion education, t(296) = 1.93, P = .06, related to concussion knowledge. Results of a hierarchical regression indicated that after entering athlete demographics, concussion knowledge, and perceived seriousness of concussions, of the 3 psychological variables in the final stage of the model, only obsessive passion was a significant predictor of athlete's attitudes to report a concussion. CONCLUSIONS Perceived seriousness of concussion, perceived threat to long-term health, and obsessive passion were the strongest predictors of athlete's willingness to report concussions. Athletes who did not believe concussions posed a threat to their current or future health, and those that held an obsessive passion for sport were most at risk for not reporting concussions. Future research should continue to investigate the relationship between reporting behaviors and psychological factors.
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Affiliation(s)
| | - Megan Byrd
- Georgia Southern University, Statesboro, GA,USA
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28
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Putukian M, Yeates KO. Clinical Commentary: Depression and Anxiety in Adolescent and Young Adult Athletes. J Athl Train 2023; 58:681-686. [PMID: 37971042 PMCID: PMC11215733 DOI: 10.4085/1062-6050-0658.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Mental health (MH) symptoms and disorders are common in adolescents and young adults, and athletes may be at risk due to sport-specific triggers such as injury or illness as well as stressors related to performance, transition, or retirement from sport. Anxiety and depression are reported frequently in this age group, and early recognition and treatment can improve outcomes. The medical team (eg, athletic trainers or therapists, team physicians) should be familiar with the symptoms of depression and anxiety, recognize "red flags" for these symptoms and disorders, and seek to provide screening assessments and develop MH plans and MH emergency action plans. As a part of their scope of practice, team physicians should have the initial assessment and management of patients with these MH conditions and appreciate the importance of referrals to other MH providers with expertise caring for athletes. Athletic trainers are often the first point of contact for athletes who may be experiencing MH symptoms and therefore play a key role in early recognition and referrals to team physicians for early diagnosis and treatment. Additional resources that provide more in-depth information regarding the treatment and management of anxiety and depression are provided herein.
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29
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Uddin N, Acter T, Rashid MH, Chowdhury AI, Jahan EA. Coping with the COVID-19 pandemic by strengthening immunity as a nonpharmaceutical intervention: A major public health challenge. Health Sci Rep 2023; 6:e1562. [PMID: 37720166 PMCID: PMC10500053 DOI: 10.1002/hsr2.1562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
Background and Aims The global Coronavirus-2 outbreak has emerged as a significant threat to majority of individuals around the world. The most effective solution for addressing this viral outbreak is through vaccination. Simultaneously, the virus's mutation capabilities pose a potential risk to the effectiveness of both vaccines and, in certain instances, newly developed drugs. Conversely, the human body's immune system exhibits a robust ability to combat viral outbreaks with substantial confidence, as evidenced by the ratio of fatalities to affected individuals worldwide. Hence, an alternative strategy to mitigate this pandemic could involve enhancing the immune system's resilience. Methods The research objective of the review is to acquire a comprehensive understanding of the role of inflammation and immunity in COVID-19. The pertinent literature concerning immune system functions, the impact of inflammation against viruses like SARS-CoV-2, and the connection between nutritional interventions, inflammation, and immunity was systematically explored. Results Enhancing immune function involves mitigating the impact of key factors that negatively influence the immune response. Strengthening the immune system against emerging diseases can be achieved through nonpharmaceutical measures such as maintaining a balanced nutrition, engaging in regular exercise, ensuring adequate sleep, and managing stress. Conclusion This review aims to convey the significance of and provide recommendations for immune-strengthening strategies amidst the ongoing COVID-19 pandemic.
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Affiliation(s)
- Nizam Uddin
- Department of Nutrition and Food Engineering, Faculty of Allied Health ScienceDaffodil International UniversityDhakaBangladesh
| | - Thamina Acter
- Department of Mathematical and Physical SciencesEast West UniversityDhakaBangladesh
| | - Md. Harun‐Ar Rashid
- Department of Nutrition and Food Engineering, Faculty of Allied Health ScienceDaffodil International UniversityDhakaBangladesh
| | - Akibul Islam Chowdhury
- Department of Nutrition and Food Engineering, Faculty of Allied Health ScienceDaffodil International UniversityDhakaBangladesh
| | - Effat Ara Jahan
- Department of Nutrition and Food Engineering, Faculty of Allied Health ScienceDaffodil International UniversityDhakaBangladesh
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30
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Ackerman KE, Rogers MA, Heikura IA, Burke LM, Stellingwerff T, Hackney AC, Verhagen E, Schley S, Saville GH, Mountjoy M, Holtzman B. Methodology for studying Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the International Olympic Committee (IOC) consensus on REDs. Br J Sports Med 2023; 57:1136-1147. [PMID: 37752010 DOI: 10.1136/bjsports-2023-107359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/28/2023]
Abstract
In the past decade, the study of relationships among nutrition, exercise and the effects on health and athletic performance, has substantially increased. The 2014 introduction of Relative Energy Deficiency in Sport (REDs) prompted sports scientists and clinicians to investigate these relationships in more populations and with more outcomes than had been previously pursued in mostly white, adolescent or young adult, female athletes. Much of the existing physiology and concepts, however, are either based on or extrapolated from limited studies, and the comparison of studies is hindered by the lack of standardised protocols. In this review, we have evaluated and outlined current best practice methodologies to study REDs in an attempt to guide future research.This includes an agreement on the definition of key terms, a summary of study designs with appropriate applications, descriptions of best practices for blood collection and assessment and a description of methods used to assess specific REDs sequelae, stratified as either Preferred, Used and Recommended or Potential Researchers can use the compiled information herein when planning studies to more consistently select the proper tools to investigate their domain of interest. Thus, the goal of this review is to standardise REDs research methods to strengthen future studies and improve REDs prevention, diagnosis and care.
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Affiliation(s)
- Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Margot Anne Rogers
- Australian Institute of Sport, Bruce, South Australia, Australia
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australian Capital Territory, Australia
| | - Ida A Heikura
- Canadian Sport Institute-Pacific, Victoria, British Columbia, Canada
- Department of Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Louise M Burke
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Trent Stellingwerff
- Canadian Sport Institute-Pacific, Victoria, British Columbia, Canada
- Department of Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Anthony C Hackney
- Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports and Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Stacey Schley
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Grace H Saville
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Margo Mountjoy
- Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
- Games Group, International Olympic Committee, Lausanne, Switzerland
| | - Bryan Holtzman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Mass General for Children, Boston, Massachusetts, USA
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31
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Pensgaard AM, Sundgot-Borgen J, Edwards C, Jacobsen AU, Mountjoy M. Intersection of mental health issues and Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs. Br J Sports Med 2023; 57:1127-1135. [PMID: 37752005 DOI: 10.1136/bjsports-2023-106867] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/28/2023]
Abstract
Overall athlete health is a stated priority by the International Olympic Committee (IOC), yet it can be difficult for athletes to safely balance nutritional needs, training load, recovery, social interactions, expectations and other demands. The effect of energy intake and, especially, low energy availability (LEA) on athlete mental health, is understudied. In this narrative review, we examine research that has included psychological factors and mental health variables when investigating the effect of LEA, dieting/restrictive eating and Relative Energy Deficiency in Sport (REDs), since the 2018 IOC consensus statement on REDs. Based on currently available data, early psychological indicators associated with problematic LEA are mood changes, fatigue and psychological conflict. More severe mental health outcomes associated with REDs are reduced well-being, elevated anxiety, depressive symptoms and eating disorders. We propose a psychological model that helps structure how possible risk factors (eg, body dissatisfaction, environmental demands or increased training load) and moderating (eg, gender, sport) and/or potential mediating (eg, social climate, self-esteem) factors are associated with LEA and ultimately REDs. The current scientific literature underscores the importance of including mental health factors when screening for REDs and for developing a clinical approach to address the psychological sequelae of REDs once diagnosed. An interdisciplinary perspective is recommended. Lastly, and importantly, the athlete perspective urges clinicians to not underestimate the drive for success and denial of health consequences that athletes demonstrate when pursuing their sport goals.
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Affiliation(s)
| | | | - Carla Edwards
- McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | | | - Margo Mountjoy
- Association for Summer Olympic International Federations (ASOIF), Lausanne, Switzerland
- Department of Family Medicine, Hamilton, Hamilton, Ontario, Canada
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32
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Leiszler M, Holtz J, Ward C. The Preparticipation Physical Examination for American Football Athletes. HSS J 2023; 19:292-298. [PMID: 37435121 PMCID: PMC10331274 DOI: 10.1177/15563316231174439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/13/2022] [Indexed: 07/13/2023]
Affiliation(s)
| | - Jacob Holtz
- Sports Medicine, South Bend-Notre Dame Sports Medicine Fellowship, South Bend, IN, USA
| | - Cody Ward
- Sports Medicine, University of Notre Dame, Notre Dame, IN, USA
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33
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Makdissi M, Critchley ML, Cantu RC, Caron JG, Davis GA, Echemendia RJ, Fremont P, Hayden KA, Herring SA, Hinds SR, Jordan B, Kemp S, McNamee M, Maddocks D, Nagahiro S, Patricios J, Putukian M, Turner M, Sick S, Schneider KJ. When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review. Br J Sports Med 2023; 57:822-830. [PMID: 37316181 DOI: 10.1136/bjsports-2023-106815] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To systematically review the scientific literature regarding factors to consider when providing advice or guidance to athletes about retirement from contact or collision sport following sport-related concussion (SRC), and to define contraindications to children/adolescent athletes entering or continuing with contact or collision sports after SRC. DATA SOURCES Medline, Embase, SPORTSDiscus, APA PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials were searched systematically. STUDY ELIGIBILITY CRITERIA Studies were included if they were (1) original research, (2) reported on SRC as the primary source of injury, (3) evaluated the history, clinical assessment and/or investigation of findings that may preclude participation in sport and (4) evaluated mood disturbance and/or neurocognitive deficits, evidence of structural brain injury or risk factors for increased risk of subsequent SRC or prolonged recovery. RESULTS Of 4355 articles identified, 93 met the inclusion criteria. None of the included articles directly examined retirement and/or discontinuation from contact or collision sport. Included studies examined factors associated with increased risk of recurrent SRC or prolonged recovery following SRC. In general, these were low-quality cohort studies with heterogeneous results and moderate risk of bias. Higher number and/or severity of symptoms at presentation, sleep disturbance and symptom reproduction with Vestibular Ocular Motor Screen testing were associated with prolonged recovery and history of previous concussion was associated with a risk of further SRC. CONCLUSION No evidence was identified to support the inclusion of any patient-specific, injury-specific or other factors (eg, imaging findings) as absolute indications for retirement or discontinued participation in contact or collision sport following SRC. PROSPERO REGISTRATION NUMBER CRD42022155121.
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Affiliation(s)
- Michael Makdissi
- Australian Football League, Melbourne, Victoria, Australia
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health - Austin Campus, Heidelberg, Victoria, Australia
| | - Meghan L Critchley
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Robert C Cantu
- Neurosurgery, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jeffrey G Caron
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Québec, Canada
| | - Gavin A Davis
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Cabrini Health, Malvern, Victoria, Australia
| | - Ruben J Echemendia
- Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
- Orthopedics Center Concussion Care Clinic, State College, Pennsylvania, Pennsylvania, USA
| | - Pierre Fremont
- Rehabilitation, Laval University, Quebec, Quebec, Canada
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Stanley A Herring
- Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine and Neurological Surgery, University of Washington, Seattle, Washington, USA
| | | | - Barry Jordan
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Simon Kemp
- Sports Medicine, Rugby Football Union, London, UK
- London School of Hygiene & Tropical Medicine, London, UK
| | - Michael McNamee
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
- School of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - David Maddocks
- Perry Maddocks Trollope Lawyers, Melbourne, Victoria, Australia
| | - Shinji Nagahiro
- Department of Neurosurgery, Yoshinogawa Hospital, Tokushima, Japan
| | - Jon Patricios
- Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Margot Putukian
- Major League Soccer, Princeton University, Princeton, New Jersey, USA
| | - Michael Turner
- International Concussion and Head Injury Research Foundation, London, UK
- University College London, London, UK
| | - Stacy Sick
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn J Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
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Oguro S, Ojio Y, Matsunaga A, Shiozawa T, Kawamura S, Yoshitani G, Horiguchi M, Fujii C. Mental health help-seeking preferences and behaviour in elite male rugby players. BMJ Open Sport Exerc Med 2023; 9:e001586. [PMID: 37265779 PMCID: PMC10231004 DOI: 10.1136/bmjsem-2023-001586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/03/2023] Open
Abstract
Objectives Mental health symptoms and mental illnesses are common in elite athletes. There is an urgent need to develop care systems to support the mental health of elite athletes. Understanding elite athletes' preferences in mental health help seeking can help explore strategies to develop such systems. Therefore, this study aims to investigate with whom/where elite athletes feel comfortable discussing mental health concerns and seeking help. Methods We analyse data from 219 Japanese male rugby players out of 612 players (565 Japanese, 47 foreigners) aged 18 and over who belong to the Japan Rugby Players Association using a cross-sectional design and an anonymous, web-based, self-administered questionnaire. In the questionnaire, the players are asked to rate on a 5-point Likert scale how comfortable they feel talking about their mental health concerns with affiliation/team staff, family/relatives, friends, mental health professionals, rugby-related seniors and teammates. Analysis of variance and Dunnett's test are performed to detect differences in their preferences for sources of help. Results Dunnett's test shows that the mean scores for preferring to consult affiliation/team staff are significantly lower than for all the other groups (p<0.001), indicating that players are reluctant to seek help for mental health concerns from affiliation/team staff. Fewer players sought help from affiliation/team staff or mental health professionals than from other groups. Conclusion Regarding mental health concerns, for elite male rugby players as elite athletes, it can be difficult to ask for help or talk to team staff.
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Affiliation(s)
- Saki Oguro
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yasutaka Ojio
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Asami Matsunaga
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Mental Health and Psychiatric Nursing, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takuma Shiozawa
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | | | | | | | - Chiyo Fujii
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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Gerber M, Jakowski S, Kellmann M, Cody R, Gygax B, Ludyga S, Müller C, Ramseyer S, Beckmann J. Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 66:102387. [PMID: 37665852 DOI: 10.1016/j.psychsport.2023.102387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/22/2022] [Accepted: 01/08/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Appropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes' performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes. METHODS Participants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, Mage = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms. RESULTS Higher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = -35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes. CONCLUSIONS The findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes' mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Switzerland.
| | - Sarah Jakowski
- Faculty of Sport Science, Ruhr-University Bochum, Germany
| | - Michael Kellmann
- Faculty of Sport Science, Ruhr-University Bochum, Germany; School of Human Movement and Nutrition Sciences, University of Queensland, Australia
| | - Robyn Cody
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Basil Gygax
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Caspar Müller
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Sven Ramseyer
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Switzerland
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Canadian Academy of Sport and Exercise Medicine Position Paper: The Clinician's Role in Addressing and Preventing Maltreatment in Sport-10-year Anniversary. Clin J Sport Med 2023; 33:103-109. [PMID: 36853907 PMCID: PMC9983751 DOI: 10.1097/jsm.0000000000001129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/16/2023] [Indexed: 03/01/2023]
Abstract
ABSTRACT In 2011, the Canadian Academy of Sport and Exercise Medicine released their first position paper on Abuse, Harassment, and Bullying in Sport. Since this time, there have been significant advancements within the global sport landscape, including the emergence of regulatory bodies and initiatives aimed at prioritizing athletes' health and well-being. While the shift to a more proactive approach for safeguarding athletes is evident and promising, athletes continue to be affected by cases of maltreatment. To advance safe sport, it is critical that all supporters of safe and healthy performance are aware of their roles and responsibilities for preventing and addressing maltreatment, including the Canadian sport medicine community. In this updated position statement, recent advancements in research on issues of maltreatment are summarized and specific recommendations are provided on how the medical community can contribute to appropriately identifying, treating, and preventing harm in sport, as well as their role in advocating for the health and well-being of athletes in their care.
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Hill B, Grubic N, Williamson M, Phelan DM, Baggish AL, Dorian P, Drezner JA, Johri AM. Does cardiovascular preparticipation screening cause psychological distress in athletes? A systematic review. Br J Sports Med 2023; 57:172-178. [PMID: 36418151 DOI: 10.1136/bjsports-2022-105918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the psychological implications of cardiovascular preparticipation screening (PPS) in athletes. DESIGN Systematic review. DATA SOURCES MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, APA PsycInfo, Cochrane Library and grey literature sources. STUDY ELIGIBILITY CRITERIA Observational and experimental studies assessing a population of athletes who participated in a cardiovascular PPS protocol, where psychological outcomes before, during and/or after PPS were reported. METHODS Results of included studies were synthesised by consolidating similar study-reported measures for key psychological outcomes before, during and/or after screening. Summary measures (medians, ranges) were computed across studies for each psychological outcome. RESULTS A total of eight studies were included in this review (median sample size: 479). Study cohorts consisted of high school, collegiate, professional and recreational athletes (medians: 59% male, 20.5 years). Most athletes reported positive reactions to screening and would recommend it to others (range 88%-100%, five studies). Increased psychological distress was mainly reported among athletes detected with pathological cardiac conditions and true-positive screening results. In comparison, athletes with false-positive screening results still reported an increased feeling of safety while participating in sport and were satisfied with PPS. A universal conclusion across all studies was that most athletes did not experience psychological distress before, during or after PPS, regardless of the screening modality used or accuracy of results. CONCLUSION Psychological distress associated with PPS in athletes is rare and limited to athletes with true-positive findings. To mitigate downstream consequences in athletes who experience psychological distress, appropriate interventions and resources should be accessible prior to the screening procedure. PROSPERO REGISTRATION NUMBER CRD42021272887.
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Affiliation(s)
- Braeden Hill
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Nicholas Grubic
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Dermot M Phelan
- Sports Cardiology Center, Atrium Health Sanger Heart and Vascular Institute, Charlotte, North Carolina, USA
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paul Dorian
- Department of Medicine, Division of Cardiology, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan A Drezner
- Center for Sports Cardiology, University of Washington, Seattle, Washington, USA
| | - Amer M Johri
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
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Gajardo-Burgos R, Valdebenito-Tejos C, Gálvez-García G, Bascour-Sandoval C. Pain and Psychological Readiness to Return to Sport in Elite Volleyball Players: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2492. [PMID: 36767858 PMCID: PMC9915367 DOI: 10.3390/ijerph20032492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 06/18/2023]
Abstract
UNLABELLED Pain is modulated by multiple factors. A relevant psychological process peculiar to athletes and which could be associated with pain is Psychological Readiness to Return to Sport (PRRS). The analysis of this association in competition context is particularly important. OBJECTIVE To determine the correlation between the PRRS and pain intensity in elite volleyball players during their participation in a continental sporting event. METHODS A cross-sectional study was conducted. Data from 107 male volleyball players (23.50 ± 4.08 years of age) participating in the South American Volleyball Championship were used. The athletes answered a self-report questionnaire on the day the championship began regarding their history of injuries in the previous six months. The athletes who declared injuries were asked about the current pain intensity using the Pain Numeric Rating Scale (NRS) and Psychological Readiness to Return to Sport using the Injury-Psychological Readiness to Return to Sport scale (I-PRRS). RESULTS 43.93% (n = 47) of the athletes (23.70 ± 3.54 years) reported an injury in the six months prior to the championship. They presented a median on the NRS of three (interquartile range (IQR), 2-5), and 54 (IQR, 46-58) on the I-PRRS. The Spearman's Rho correlation test showed an inversely and moderate correlation (rs = -0.36; p = 0.011; CI: -0.64--0.08) between pain intensity and PRRS. CONCLUSIONS In male elite volleyball players who participate in a Continental Championship in South America, higher levels of PRRS was correlated to lower pain intensity.
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Affiliation(s)
- Rubén Gajardo-Burgos
- Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5090000, Chile
- Programa de Magister en Terapia Física, Mención Musculoesquelética, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
| | - Camila Valdebenito-Tejos
- Dirección de Desarrollo Estudiantil, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
| | - Germán Gálvez-García
- Departamento de Psicología, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
- Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Campus Ciudad Jardín, Universidad de Salamanca, 37005 Salamanca, Spain
| | - Claudio Bascour-Sandoval
- Programa de Magister en Terapia Física, Mención Musculoesquelética, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
- Departamento de Ciencias de la Rehabilitación, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
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Myall K, Montero-Marin J, Gorczynski P, Kajee N, Syed Sheriff R, Bernard R, Harriss E, Kuyken W. Effect of mindfulness-based programmes on elite athlete mental health: a systematic review and meta-analysis. Br J Sports Med 2023; 57:99-108. [PMID: 36223914 DOI: 10.1136/bjsports-2022-105596] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the effectiveness of mindfulness-based programmes (MBPs) on the mental health of elite athletes. DESIGN Systematic review and meta-analysis. DATA SOURCES Eight online databases (Embase, PsycINFO, SPORTDiscus, MEDLINE, Scopus, Cochrane CENTRAL, ProQuest Dissertations & Theses and Google Scholar), plus forward and backward searching from included studies and previous systematic reviews. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies were included if they were randomised controlled trials (RCTs) that compared an MBP against a control, in current or former elite athletes. RESULTS Of 2386 articles identified, 12 RCTs were included in this systematic review and meta-analysis, comprising a total of 614 elite athletes (314 MBPs and 300 controls). Overall, MBPs improved mental health, with large significant pooled effect sizes for reducing symptoms of anxiety (hedges g=-0.87, number of studies (n)=6, p=0.017, I 2=90) and stress (g=-0.91, n=5, p=0.012, I 2=74) and increasing psychological well-being (g=0.96, n=5, p=0.039., I 2=89). Overall, the risk of bias and certainty of evidence was moderate, and all findings were subject to high estimated levels of heterogeneity. CONCLUSION MBPs improved several mental health outcomes. Given the moderate degree of evidence, high-quality, adequately powered trials are required in the future. These studies should emphasise intervention fidelity, teacher competence and scalability within elite sport. PROSPERO REGISTRATION NUMBER CRD42020176654.
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Affiliation(s)
- Kearnan Myall
- Department of Psychiatry, Oxford University, Oxford, UK
| | - Jesus Montero-Marin
- Department of Psychiatry, Oxford University, Oxford, UK .,Teaching, Reseach and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Paul Gorczynski
- School of Human Science, University of Greenwich, London, UK
| | - Nabeela Kajee
- Department of Psychiatry, Oxford University, Oxford, UK
| | - Rebecca Syed Sheriff
- Department of Psychiatry, Oxford University, Oxford, UK.,Oxford Health NHS Foundation Trust, NHS, Oxford, UK
| | - Robert Bernard
- Department of Education, Concordia University, Montreal, Quebec, Canada
| | - Eli Harriss
- Bodleian Health Care Libraries, Oxford University, Oxford, UK
| | - Willem Kuyken
- Department of Psychiatry, Oxford University, Oxford, UK
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Antoniak K, Tucker C, Rizzone K, Wren TAL, Edison B. Athlete Identity and Mental Health of Student Athletes during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17062. [PMID: 36554940 PMCID: PMC9779176 DOI: 10.3390/ijerph192417062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
The purpose of our study is to evaluate athletic identity (AI) and mental health measures of youth and young adult athletes during the COVID-19 pandemic. This cross-sectional study recruited athletes aged 11-25 years from universities, high schools, and middle schools in California and New York. Participants were emailed a link to an anonymous, cross-sectional electronic survey. The measure included the athletic identity measurement scale (AIMS), the Patient Health Questionnaire-4 (PHQ-4), and demographic variables. Chi-square, Fisher's Exact Test, and linear regression were used to examine the relationships between AI, symptoms of anxiety, and symptoms of depression by age, gender, and race. The survey was completed by 653 participants. AI was stratified by tertiary percentiles. The odds of positively scoring for symptoms of anxiety were 60% higher for participants in college compared with high school (OR: 1.60, 95% CI: [1.09, 2.35]). Conversely, the odds of scoring positively for symptoms of depression were 68% higher for participants in high school compared to college (OR: 1.68, 95% CI: [1.09, 2.59]). The odds of scoring positively for symptoms of depression were higher for athletes who scored as high AI, compared to those who scored as moderate (OR: 1.72, 95% CI: [1.11, 2.68]) or low (OR: 1.93, 95% CI: [1.20, 3.12]). The odds of scoring positively for symptoms of anxiety on the PHQ-4 were 3.2 times higher for participants who identified as female (OR: 3.19, 95% CI: [2.31, 4.41]), and the odds of scoring positively for symptoms of depression were 2.4 times higher for participants who identified as female (OR: 2.35, 95% CI: [1.56, 3.54]). Female athletes experienced symptoms of depression and anxiety at significantly higher rates than male athletes during the COVID-19 pandemic. High school students experienced fewer symptoms of anxiety, but greater symptoms of depression as compared to the collegiate group, while college students experienced greater odds of symptoms of anxiety. Athletes in the high AI group were more likely to report symptoms of depression than moderate or low identity groups. Female athletes reported lower AI than male athletes, but still had greater symptoms of anxiety and depression.
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Affiliation(s)
| | - Clea Tucker
- School of Kinesiology, California State University Los Angeles, Los Angeles, CA 90032, USA
| | - Katherine Rizzone
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, NY 15618, USA
| | | | - Bianca Edison
- Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Pilkington V, Rice SM, Walton CC, Gwyther K, Olive L, Butterworth M, Clements M, Cross G, Purcell R. Prevalence and Correlates of Mental Health Symptoms and Well-Being Among Elite Sport Coaches and High-Performance Support Staff. SPORTS MEDICINE - OPEN 2022; 8:89. [PMID: 35792942 PMCID: PMC9259770 DOI: 10.1186/s40798-022-00479-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/14/2022] [Indexed: 11/22/2022]
Abstract
Background There is growing understanding of mental health needs in elite athletes, but less is known about the mental health of coaches and support staff who work within elite sport settings. This study examined the prevalence and correlates of mental health symptoms in elite-level coaches and high-performance support staff (HPSS) and compared rates against published elite athlete samples. A cross-sectional, anonymous, online survey was administered to coaches and HPSS working in Australia’s high-performance sports system. Main outcomes were scores on validated measures of psychological distress, probable ‘caseness’ for a diagnosable psychological condition, alcohol consumption and sleep disturbance. Results Data were provided by 78 coaches (mean age = 46.4 years, 23.8% female) and 174 HPSS (mean age = 40.0 years, 56.7% female). Overall, 41.2% of the sample met probable caseness criteria, 13.9% reported high to very high psychological distress, 41.8% reported potential risky alcohol consumption and 17.7% reported moderate to severe sleep disturbance, with no statistically significant differences between coaches and HPSS. The most robust correlates of psychological distress and probable caseness were dissatisfaction with social support and dissatisfaction with life balance, while poor life balance was also associated with increased alcohol consumption and poor social support with sleep disturbance. Coaches and HPSS reported similar prevalence of mental health outcomes compared to rates previously observed in elite athletes, with the exception of higher reporting of alcohol consumption among coaches and HPSS. Conclusions Elite-level coaches and HPSS reported levels of psychological distress and probable caseness similar to those previously reported among elite-level athletes, suggesting that these groups are also susceptible to the pressures of high-performance sporting environments. Screening for mental health symptoms in elite sport should be extended from athletes to all key stakeholders in the daily training environment, as should access to programs to support mental health and well-being.
Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00479-y.
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Gattis C, Moore M. A conceptual analysis of maltreatment in sports: A sport social work perspective. Front Sports Act Living 2022; 4:1017308. [DOI: 10.3389/fspor.2022.1017308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Maltreatment in sports is an epidemic and occurs in many relational forms such as physical, sexual, and emotional abuse or neglect. Maltreatment in sports also exists in forms of non-relational abuse and focuses on mezzo and macro forms of maltreatment such as systematic abuse, organizational abuse, and physiological abuse or neglect (e.g., exploitation and athlete trafficking). It is imperative to study the effects of maltreatment in sports as athletes can be the victims (survivors) as well as perpetrators of abuse. Recent research in the field of social work points to the benefits of Trauma-Informed Sports and Short Focused Brief Therapy (SFBT) as possible interventions. It is imperative for transferability in the field of maltreatment in sports, that practitioners define each form of abuse in the context of maltreatment and trauma. This commentary aims to discuss the different forms of maltreatment in sports that could affect athletes and provide discussion and insights into the void of research surrounding certain forms of non-relational abuse and the role trauma-informed therapies serve in promoting athlete wellbeing from a social work lens.
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Liddelow C, Schweickle MJ, Sutcliffe JT, Swann C, Keegan R, Rice S, Okely AD, Vella SA. Protocol for national mental health guidelines for community sport in Australia. BMJ Open Sport Exerc Med 2022; 8:e001426. [DOI: 10.1136/bmjsem-2022-001426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/23/2022] Open
Abstract
Organised sports are the most common settings for sports participation. Despite a range of documented benefits from participation, these positive outcomes are not always guaranteed. Emotional distress from pressure and injuries can mean some participants experience negative outcomes. To ensure organised sports are well equipped to promote the mental health of their members, evidence-based guidelines for them are required. Using a Community-Based Participatory Research framework, mental health guidelines for community sport will be developed. In Phase One, community sport stakeholders will participate in focus groups. The aim is to understand their preferences of the content, purpose and scope of the guidelines. In Phase Two, an e-Delphi study will be conducted with experts in mental health and sport in Australia to gather recommendations on the purpose and scope of the guidelines. In Phase Three, a national consensus meeting with an Expert Guideline Development Committee will be held to draft the guidelines. In Phase Four, follow-up focus groups will be held with community sport stakeholders to understand the usability and acceptability of the draft guidelines. In Phase Five, a second e-Delphi study will be conducted to provide feedback on the revised guidelines after community stakeholder review. In Phase Six, implementation case studies will assess the implementation of the guidelines in community sport clubs. These mental health guidelines will answer an urgent call for action by experts. The guidelines will be based on sector needs and preferences, be acceptable and useable, and be able to be implemented by community sport clubs globally by 2025.
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Boudreault V, Labossière S, Gauthier V, Brassard S, Couture S, Dionne F, Laurier C, Durand-Bush N. Symptoms of mental illness among university student-athletes during the second wave of the COVID-19 pandemic lockdown in Canada. Front Sports Act Living 2022; 4:1017376. [PMID: 36339640 PMCID: PMC9627313 DOI: 10.3389/fspor.2022.1017376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/30/2022] [Indexed: 01/24/2023] Open
Abstract
The COVID-19 pandemic lockdown disrupted the university sports season and had negative consequences on the academic and personal life of university student-athletes, resulting in several psychological challenges. The goal of this study is to document the symptoms of mental illness among university student-athletes during the second wave of the COVID-19 pandemic lockdown in Canada. It aims to (a) assess the prevalence of mental illness symptoms (anxiety, depression, disordered eating, and dangerous drinking) among university student-athletes and (b) identify which sociodemographic and sports characteristics, pandemic impacts, and levels of perceived stress most influence these symptoms. A total of 424 university student-athletes completed an online survey, which included questions on mental illness and the impact of the pandemic lockdown. The results revealed a notable prevalence of the symptoms of mental illness; depressive symptoms are reported by 37.9% of the participants, anxiety symptoms by 24.9%, dangerous drinking symptoms by 10.1%, and disordered eating by 8.6%. In addition, being female [OR = 0.56, 95% CI (0.33, 0.95)] or a member of a visible minority group [OR = 2.63, 95% CI (1.02, 6.78)] are significantly associated with the presence of depressive symptoms. Low academic motivation has a significant negative influence on the presence of depressive [OR = 3.37, 95% CI (1.82, 6.25)] and anxiety symptoms [OR = 2.75, 95% CI (1.35, 5.62)]. However, the presence of perceived stress was strongly associated with depressive [OR = 7.07, 95% CI (3.26, 15.35)], anxiety [OR = 6.51, 95% CI (3.30, 12.84)], and dangerous drinking symptoms [OR = 5.74, 95% CI (2.51, 13.14)]. This study advocates for specific mental illness prevention and treatment resources tailored to the unique needs of university student-athletes. Accordingly, partnerships and practical interventions to support university student-athletes' mental health are presented.
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Affiliation(s)
- Véronique Boudreault
- Faculté des Sciences de l'Activité Physique, Université de Sherbrooke, Sherbrooke, QC, Canada,*Correspondence: Véronique Boudreault
| | - Sophie Labossière
- Faculté d'Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Véronique Gauthier
- Département des Sciences Humaines, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Sophie Brassard
- Faculté d'Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sophie Couture
- Faculté d'Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédérick Dionne
- Département des Sciences Humaines, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Catherine Laurier
- Faculté d'Education, Université de Sherbrooke, Sherbrooke, QC, Canada
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Bentzen M, Kenttä G, Karls T, Fagher K. Monitoring mental distress in Para athletes in preparation, during and after the Beijing Paralympic Games 2022: A 22 week prospective mixed-method study. Front Sports Act Living 2022; 4:945073. [PMID: 36304569 PMCID: PMC9592753 DOI: 10.3389/fspor.2022.945073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022] Open
Abstract
It is common in elite sport to monitor athletes' training load, injuries and illnesses, but mental distress is rarely included. An improved understanding of the epidemiology of mental distress among elite Para athletes and how their coaches perceive such monitoring would allow us to better develop and implement preventive measures. The purpose of this study was therefore to (1) prospectively describe elite Para athletes' mental distress, before, during and after the Beijing Paralympic Games (Paralympics Games 22 = PG22); and to (2) gain a better understanding of if and potentially how awareness of athletes' mental distress changed, through weekly monitoring, and influenced how coachers perceive athletes' mental distress and if they accounted for this before, during and after PG22. A mixed-method study design was used, in which prospective mental distress (depression and anxiety) data were collected weekly from 13 [Swedish] elite Para athletes in preparation, during and after PG22. Data were screened and evaluated weekly by a physiotherapist and a sports psychologist, and coaches also received weekly reports. A focus-group interview with the coaches were conducted post Paralympics to address coaches' awareness about mental distress and athlete health monitoring in Parasport. For data analyses, descriptive statistics was used for the quantitative data and a content analysis was conducted for the qualitative data. The results reveled the following proportion of datapoints indicating symptoms of anxiety and depression: before PG22 (15.8 and 19.1%); during PG22 (47.6 and 38.2%); and after PG22 (0 and 11.8%). The qualitative results indicated that coaches perceived athlete health monitoring as helpful for increasing their awareness of mental distress, and as a useful tool to initiate support for their athletes as well as improving their coaching. In summary, this cohort of elite Para athletes reported a high proportion of mental distress during the Winter Paralympic Games in Beijing. The results also show that it is important and feasible to monitor Para athletes' mental distress to detect and manage early symptoms of mental distress.
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Affiliation(s)
- Marte Bentzen
- Department of Teacher Education and Outdoor Studies, The Norwegian School of Sport Sciences, Oslo, Norway,*Correspondence: Marte Bentzen
| | - Göran Kenttä
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden,School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Tommy Karls
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden,Swedish Paralympic Committee, Stockholm, Sweden
| | - Kristina Fagher
- Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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O'Keeffe S, Ní Chéilleachair N, Campbell M, O'Connor S. Barriers and Facilitators to Mental Health Help-Seeking in Elite Gaelic Footballers Post-Injury: A Qualitative Study. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:488-503. [PMID: 34270908 DOI: 10.1080/02701367.2020.1865517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/09/2020] [Indexed: 06/13/2023]
Abstract
Purpose: Injury can exacerbate mental health issues in athletes. However, the prevalence of mental health issues is not equivalent to the rate of professional help-seeking, with reluctance to seek-help acknowledged as one of the greatest obstacles in efficient management of mental health issues. The current study aimed to examine perceived barriers and facilitators to professional mental health help-seeking in elite male and female Gaelic footballers post-injury. Methods: Male (n = 14) and female (n = 12) elite Gaelic footballers, with a history of moderate or severe injury, were recruited to participate in a focus group. Group discussions began with a written task where participants noted perceived barriers to help-seeking followed by a group discussion of these barriers. Following discussion, participants ranked identified barriers in order of those perceived as most important in stopping a player from seeking help when experiencing mental health issues post-injury. All three tasks were repeated for help-seeking facilitators. Focus groups were audiotaped, transcribed and thematically analyzed. Results: Lack of education, stigma, negative attitudes to help-seeking and accessibility issues were identified as key barriers to help-seeking among elite Gaelic footballers. Education, the attitudes and actions of others and accessibility were perceived as factors facilitating help-seeking. Conclusions: Given the negative psychological responses that can accompany injury, there is a need for facilitation and encouragement of help-seeking among players experiencing mental health issues post-injury. Interventions for reducing the barriers to help-seeking identified in the current study are necessary.
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Brooks TJ, Bradstreet TC, Partridge JA. Current concepts and practical applications for recovery, growth, and peak performance following significant athletic injury. Front Psychol 2022; 13:929487. [PMID: 36072042 PMCID: PMC9443689 DOI: 10.3389/fpsyg.2022.929487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
For decades, physicians, athletic trainers, and other health care professionals have worked to standardize the recovery process following injury to enhance patient outcomes and to help set appropriate goals for return to competition. Traditionally, these efforts have focused primarily on physical and/or physiological aspects of healing with little consideration for psychological aspects. Concurrently, mental health professionals who work with athletes have developed strategies to enhance performance and minimize negative influences of mental aspects of recovery while promoting approaches that include mental as well as physical recovery. Several strategies have emerged that further encourage a multi-faceted and interdisciplinary approach when helping injured patients return to participation. While important in a healthy population, the practical applications of these strategies are likely more critical for an athlete working through the recovery process with an ultimate goal of returning to competition. Despite these realities, both practical experience and a dearth of literature point to the traditional athletic healthcare providers’ common focus on physical aspects of recovery and psychological professionals’ focus primarily on mental aspects has resulted in sub-optimal outcomes compared to the likely benefits of an integrated approach. This article is intended to characterize current concepts in the fields of sport psychology and mental health concerning the importance of mental aspects of recovery in returning to play. Next, the authors will examine how modern theories can influence practice and discuss how these strategies can be effectively integrated and leveraged to enhance recovery and the athlete’s enjoyment of the rehabilitation and ultimately restoration process.
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Affiliation(s)
- Toby J Brooks
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Tyler C Bradstreet
- Department of Intercollegiate Athletics, Texas Tech University, Lubbock, TX, United States
| | - Julie A Partridge
- College of Health and Human Sciences, School of Human Sciences, Southern Illinois University at Carbondale, Carbondale, IL, United States
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Macpherson MC, Harrison R, Marie D, Miles LK. Investigating coaches' recognition of symptoms of eating disorders in track athletes. BMJ Open Sport Exerc Med 2022; 8:e001333. [PMID: 36071860 PMCID: PMC9394206 DOI: 10.1136/bmjsem-2022-001333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To determine the extent to which athletics coaches can identify evidence of an eating disorder in track athletes and what treatment advice they would provide. Methods Vignettes depicting athletes portraying symptoms consistent with anorexia nervosa (AN) and bulimia nervosa (BN) were developed and used to survey 185 UK and Irish athletics coaches (and a community sample of 105 non-coaches) regarding their ability to recognise and respond to symptoms of an eating disorder. Results Coaches were no more likely than the community sample to correctly identify an eating disorder but were more likely to suggest professional treatment for an athlete experiencing symptoms of AN (OR 1.82, 95% CI 1.02 to 3.29). For both eating disorders, higher levels of mental health literacy (AN: OR 1.06, 95% CI 1.02 to 1.11, BN: OR 1.08, 95% CI 1.04 to 1.14) and more years of coaching experience (AN: OR 1.12, 95% CI 1.03 to 1.24, BN: OR 1.07, 95% CI 1.01 to 1.16) also increased the likelihood of suggesting professional help. When considering the whole sample, participants were more likely to correctly identify an eating disorder (OR 4.67, 95% CI 2.66 to 8.20) and suggest professional treatment for AN than BN (OR 1.76, CI 1.04 to 2.97). Further, symptoms of AN were more likely to be correctly identified in female than male athletes (OR 2.26, 95% CI 1.28 to 4.06). Conclusions Although coaches were more likely than community members to recommend professional treatment to an athlete exhibiting symptoms of an eating disorder, they were no more likely to correctly identify an eating disorder in the first instance. Further work is required to enhance coaches' capacity to identify symptoms of eating disorders to ensure athletes receive appropriate interventions.
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Affiliation(s)
| | | | - Dannette Marie
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Lynden K Miles
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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Psychological capital and positive mental health of student-athletes: Psychometric properties of the sport psychological capital questionnaire. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03272-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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